Megaloblastic Anemia: Treatment, Procedure, Cost and Side Effects

Megaloblastic anemia is defined as a kind of blood disorder in which the number of red blood cells is generally lower than the normal count. Red blood cells are known as the transporters of oxygen throughout the body. In case your body doesn’t have enough red blood cells, the organs and tissues don’t receive enough oxygen. There are several types of anemia characterized by different causes. In megaloblastic anemia the count of red blood cells is more than normal. There are usually not enough of them. It is also called by different names including microcytic anemia, and folate or vitamin B-12 deficiency anemia. Low production of red blood cells leads to megaloblastic anemia. When the cells are too large they might not be able to exit the bone marrow and enter the bloodstream to deliver oxygen. This is caused by megaloblastic anemia.

In case you are facing megaloblastic anemia through the deficiency of vitamin B-12 then your doctor may recommend you to take monthly injections of vitamin B-12. Oral supplements are also given to the patient. Addition of vitamin B-12 induced food items to your diet may prove beneficial for treating this condition. On the other hand, megaloblastic anemia caused by lack of folate is treated with intravenous or oral folic acid supplements.

Most patients are treated with folate or cobalamin once myelosysplasia-related megaloblastosis and drug-induced megaloblastic changes have been eliminated. Many patients do not require transfusions and also adjust to low haemoglobin levels because megaloblastic anemias develop gradually. Transfusion therapy should be confined to patients with uncompensated, severe and life-threatening anemia.

In case of folate therapy, the folate should be monitored orally. If this seems difficult then there can be a parenteral administration of the doses. Also, there must be a consumption of a folate-enriched diet. The doses range from 1-5 mg daily; 1 mg/day is the normal dosage for an adult with megaloblastic anemia. On the other hand, a higher dosage is considered for alcoholism, hemolysis, malabsorption, and exfoliative dermatitis. However, a higher dose of folate may cause no harm. Another therapy, called the cobalamin therapy is given as 1000 µg daily for 2 weeks. It should then be continued on a weekly basis until the hematrocit value reaches normal, and then later on a monthly basis. A dosage of 1000 µg is usually large but is considered suitable for some patients. It is very important to put emphasis on the fact that patients with neurological or mental impairment due to cobalamin deficiency require aggressive treatment.

A patient who doesn’t have cobalamin defieciency is eligible for the folate therapy.

A patient with megaloblastic anemia who still has cobalamin deficiency is not eligible for the folate treatment because folic acid is known to rule out anemia, but not the neurological impairment due to cobalamin deficiency, and this later worsens the neurological disorder.

The side effects of the treatment include nausea, vomiting, fever, stomach ache, headaches, feeling dizzy and many more.

Improvements are needed to be monitored even if the patient starts feeling better after the therapy. There are certain laboratory tests which need to be done. These include complete blood cell count, lactate dehydrogenase (LDH) level, hemoglobin level, serum ferritin, reticulocyte count, indirect bilirubin, and serum potassium level. Required supplements must be elevated. The hemoglobin is supposed to increase approximately 1g/dL every week. The rise of the hemoglobin level is essential for monitoring a response. If the hemoglobin is not normal within 2 months, other sources of anemia, such as the deficiency of iron should be considered. A proper diet including fruits and green leafy vegetable cooked in olive oil will be beneficial.

It takes about 2 months for a patient to carry on with his therapy and then recover under proper administration of a health care provider with proper medications and a balanced diet induced with vitamin B-12.

The price of the treatment ranges from Rs. 2,000 to Rs. 5,000.

As the treatment may remove the indications of this condition, there is not much known about its long term effects. Vitamin B-12 and folate deficiency may lead to this condition again.

The alternative treatment methods for megaloblastic anemia include antibiotic treatment, usage of medicinal plants to stimulate the organism to produce vitamins, usage of appropriate supplements, and adopting a suitable diet.